台灣常見臨床念珠菌分離株對Fluconazole及Voriconazole的藥敏型式

The Fluconazole and Voriconazole Susceptibilities of Candida Isolates Commonly Encountered in Clinical Laboratories

張（王季）綸(Chi-Lun Chang) ； 王紹鴻(Shao-Hung Wang) ； 蔡文城(Wen-cherng Tsai)

《檢驗及品保雜誌》 5卷3期 (2016/08) Pp. 79-83

https://doi.org/10.6573/JTQA.201608_5(3).01

摘要

近年來，台灣從臨床檢體分離酵母菌有增加的趨勢，而Fluconazole及Voriconazole常作為酵母菌(尤其是念珠菌)治療藥物，為了避免藥物濫用及治療時在病人產生的副作用，測定分離菌對此兩種抗真菌藥物的藥敏型式有其重要性及必要性。本研究以臨床及檢驗室標準機構(CLSI)建議的M44-A2瓊脂紙錠擴散試驗方法測試128株念珠菌台灣分離株（包括43株C. albicans、38株C. tropicalis，28株C. glabrata、10株C. parapsilosis、8株C. krusei及1株C. lusitaniae）對25 μg fluconazole及1 μg voriconazole紙錠的感受性，結果指出所有臨床酵母菌分離株對fluconazole及voriconazole的感受性均為67.2% (86/128)，其中C. albicans 及C. lusitaniae皆對此兩種抗真菌藥物呈感受性；C. glabrata、C. krusei、C. parapsilosis及C. tropicalis對fluconazole的抗藥性(S-DD 及R)分別依序為64%、63%、40%及39%，而對voriconazole則分別依序為57%、50%、30%及50%。此藥敏型式對尚未執行酵母菌藥敏試驗的醫院，將可作為醫師治療酵母菌感染患者的參考。

關鍵字

念珠菌台灣分離株 ； Fluconazole及Voriconazole ； 藥敏型式

並列摘要

Recently, there has been an increasing trend of yeasts found in clinical specimens. Two antifungal agents, fluconazole and voriconazole, are commonly used to treat infections caused by yeasts, especially those caused by Candida spp. Therefore, it became necessary and important for a laboratory to perform antifungal susceptibility tests with these two agents. We followed the guidelines for the agar disk diffusion test method (M44-A2) recommended by the Clinical and Laboratory Standards Institute (CLSI) to perform antifungal susceptibility tests on 128 strains of yeasts (including 43 strains Candida albicans, 38 strains C. tropicalis, 28 strains C. glabrata, 10 strains C. parapsilosis, 8 strains C. krusei and 1 strain C. lusitaniae) by using 25 μg fluconazole and 1 μg voriconazole disks. The results indicated that 67.2% (86/128) of the isolated yeast strains were susceptible to both fluconazole and voriconazole. Among the yeast isolates, C. albicans and C. lusitaniae were 100% susceptible to these two agents, whereas the resistant rates of C. glabrata, C. krusei, C. parapsilosis and C. tropicalis to voriconazole were 64%, 63%, 40%, and 39%, respectively. In addition, the resistant rates of those isolates to voriconazole were 57%, 50%, 30% and 50%, respectively. The antibiograms obtained using the above-mentioned method can be used as references for treating infections caused by Candida spp. in those hospitals that have not performed these antifungal susceptibility tests.

並列關鍵字

fluconazole and voriconazole ； antibiograms ； Candida spp